The simple truth is that for all the problems with private health insurance for the young and working age populations, it just doesn't work for seniors. We tried it. That's why we ended up creating Medicare.

The Ryan plan is to get rid of Medicare and in place of it give seniors a voucher to buy health care insurance from private insurers. Now, what if you can't buy as much as insurance or as much care as you need? Well, start saving now or just too bad.

Now, by any reasonable standard, that's getting rid of Medicare. Abolishing Medicare. Phasing it out. Whatever you want to call it. Medicare is this single payer program that guarantees seniors health care, as noted above. Ryan's plan pushes seniors into the private markets and give them a voucher. That's called getting rid of the program. There's simply no ifs or caveats about. That's not cuts or slowing of the growth. That's abolishing the whole program. Saying anything else is a lie.

you do not want to outlive your money......sad state of affairs....i see this from both sides however...on really dark days...i wonder why i am concerned about my mothers physical health...esp as i see her mental decline...seems i am keeping a body alive that no longer has a driver...the simple costs of maintaining can be overwhelming ...

you do not want to outlive your money......sad state of affairs....i see this from both sides however...on really dark days...i wonder why i am concerned about my mothers physical health...esp as i see her mental decline...seems i am keeping a body alive that no longer has a driver...the simple costs of maintaining can be overwhelming ...

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That same basic sentiment is what was all behind the "death Panels" brouhaha a couple of years ago.

a 70 year old person who can still enjoy life as opposed to a 70 year old person who is bound to a wheelchair in a nursing home is two different scenarios. One of which, I'd be glad for any intervention that keeps me mobile and happy. The other? I think I'd rather let nature take it's course and be pushing up daisies.

And if most of us are honest with themselves, we'd feel pretty much the same way.

letting nature take its course is a lot easier said than done...i had to intervene with my mother when she began to destroy her kidneys with otc drugs....my mother knows who i am...she knows my son etc....its so sad to watch....like the other day.....i said we are going to tj maxx's to shop...she loved tj's....she ask me what is tj maxx's 'a grocery store'....before i could say anything she says 'i use to buy clothes from there' it was like she was realizing she didnt know things or i am not sure.....it simply breaks my heart. sometimes i am so tempted just to give her the otc drugs...and let her go....

One way or another, we need to find ways to reduce costs, and I mean the actual costs of treating people. That must include keeping people healthier so that they don't become a burden on the system. Obviously some people just become sick through no doing of their own. However, people who smoke and are overweight, they become long term liabilities. Not only do their healthcare costs increase dramatically, they also contribute less to the system as they tend to be less productive in their jobs.

On the other side, we need to make people work longer. This would accomplish two goals. It would mean that retirees would collect from the system for a shorter period of time, thereby reducing costs. On top of that, it would also mean that these same people would contribute to the system for a longer period of time, thereby increasing revenues.

Ryan's plan does only addresses one issue, and that is the amount government will pay toward the care of the elderly. It does not reduce costs to the individual. In fact, it most likely will increase costs to the individual. In the end, his plan does nothing to make things better or to reduce costs. We need to work toward finding solutions that not only work, but also that make sense, and that will not leave millions of people with no care at all.

I heard on the radio that something like 50 percent of all our medical costs are spent in the person's last year of life.

That's a problem.

That means we are using extraordinary measures to keep people alive who shouldn't be kept alive.

So yes, kill grandma.

No, don't allow extreme pain. Give happy drugs. But don't keep performing costly procedures on 86-year-olds that will only have benefits for six months before another problem sets in...

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If treatment can extend a person's life for a substantial period of time, then treatment should be given. One of the biggest problems though, seems to be that we will do anything to extend life, regardless of the quality of life, and quite often for an extra month, maybe two extra weeks. That is when we are throwing money away. At a cost of $8000 per day, that extra month costs $240,000. And the patient is sedated the vast majority of the time. It just makes no sense.

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